进展期胃癌胃下中医辨证分型探讨.pdfVIP

提 要 目的：探讨进展期胃癌各中医证型的胃镜下典型表现，为中医辨证治疗提供客观 依据。方法：1.临床选择符合纳入标准的进展期胃癌患者 51 例，结合文献研究制定 临床观察表，收集病历；2.通过胃镜下观察51例患者的黏膜表现，与传统中医的望、 闻、问、切四诊相结合，并进行数据录入；3.采用 SPSS17.0 统计软件处理分析，对 进展期胃癌的中医证候规律进行分析。结果：胃镜下两种证型与肿瘤部位及胃癌 Borrmann 分期之间没有显著性差异（P0.05），但是与肿瘤表面是否有溃疡、是否 有活动性出血、Hp 感染、舌质、舌苔表现出一定的相关性；脾胃虚弱型患者比较明 显的胃镜像为肿瘤隆起少见溃疡；粘膜充血水肿，出血在瘀毒内蕴型中较明显；脾胃 虚损证患者胃镜下肿瘤溃疡面积小于瘀毒内蕴型；Hp 感染在瘀毒内蕴证中多见；淡 白舌白腻苔在脾胃虚弱证中较多见；舌暗红苔薄黄在瘀毒内蕴型中多见，均具有统计 学意义（P0.05）。结论：胃镜下两种证型与肿瘤部位及胃癌Borrmann分期之间没有 显著性差异，但是与肿瘤表面是否有溃疡、是否有活动性出血、Hp 感染、舌质、舌 苔表现出一定的相关；脾胃虚损证患者胃镜下见少见溃疡，且溃疡面积最小，淡白舌 白腻苔。瘀毒内蕴证患者胃镜下多见溃疡与活动性出血，溃疡面积较大，HP 感染阳 性，暗红舌苔薄黄。 关键词 进展期胃癌；胃镜；中医证型 Gastroscope Performance of Advanced Gastric Cancer and the Relevance of TCM Syndrome Types Research Speciality : Chinese medicine Clinical Author:Wang yongsen Tutor: Professor Cao zhiqun Abstract: Objective: The aim of this study was to explore the typical performance of TCM syndrome type of advanced gastric cancer under gastroscope and provide an objective basis for TCM treatment. Methods: 1. 51 cases of advanced gastric cancer met the inclusion criteria were selected in the clinical, then combination of the basis of the literature to develop clinical observation table and collect of cases. 2. Combining with the traditional Chinese look, smell, and asked, cutting the four diagnostic , to observe the mucous membrane performance of the 51 patients under gastroscope and data entry. 3.Processing and analysis using statistical software SPSS13.0 to analysis the Chinese medicine symptom law of advanced gastric cancer. Results:There is no significant difference between the two syndrome types of tumor and gastric cancer Borrmann stages under gastroscope （P0.05 ）,bu